Week #6 - Social and Ethical Issues (due 2/25)

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Antoine and Naomi's first child has cystic firbrosis. They would like to have a second child but want to make sure the child does not have cystic fibrosis. After in vitro fertilization, seven embryos are screened for the presence of the disease. Of the seven, two are determined to have the disease. Prior to preimplantation, Antoine and Naomi asked the doctor to screen the remaining "healthy" five embryos for gender as they want to have only one more child, and they want that child to be a boy to carry on the family name. What would you tell the couple if you were the doctor? Is there a difference, in your opinion, between screening for a genetic disease and gender? If a genetic test for a phenotype exists, should the screening be available (e.g., if Antoine and Naomi asked to select an embryo carrying the genes to express blue eyes and blond hair should they be able to do so)? What are some potential implications of selecting for alleles that do not have an impact on survival? What types of genetic screening, if any, should be available?

Comments

Blog 6

I think that this is a really sticky situation and I tried to put my self in the shoes of the parents. I would definetly want to be able to sceen embryos for cystic fibrosis, but I definetly do not think that I should be able to choose the sex of my baby. I feel as though the parents should not be able to choose the gender od the baby, but then some might argue that this is the same as screening for the disease. Maybe we should leave everything up to chance, but if you know that you had the opportunity to prevent your child from being born with a disease, I am sure that any parent would take that opportunity.

Week 6

When it comes to being able to screen an embryo for a type of genetic defect that may cripple or hinder the child's ability to live a normal life, I believe, detection is warranted. However screening an embryo for physical traits that have no impact on the child's health should not be utilized. If parents are allowed to pick and choose the traits their children have where do we draw the line. Allowing to prevent disease is one thing but non-survival traits should be inherited at random. The ability to choose will only inevitably feed into discrimination and social isolation of specific traits.

Week 6 Blog Entry

It is one thing to perform a screen for healthy embryos and another to request sex, eye color, and other alleles unrelated to survival be selected for or against. As the doctor I would have to say that I am unable to perform such a screen. Performing multiple tests on these embryos may have detrimental effects as a result of the harsh sampling methods used (removing DNA, etc). Further, traits that ensure your child's health are the only traits I think are necessary for screening. The implications of allowing such a screen to occur will result in eugenics. Much of the diversity of a population could be decreased because the 'ideals' of that society lie in similar alleles.

Week six

In my opinion, there is definitely a difference in screening for a genetic disorder and screening for gender. However, I'm not sure that I have an issue with people screening for the gender of their child. While I understand that this comes very close to unethical, I think screening for gender just makes the cut. Eye color, hair color, personality however, I do no find acceptable. If screening for gender was allowed, it would have to be controlled very strictly. Maybe a couple should only be allowed to screen after their first child? I think that there is a way that could be found to do it that would be moral. Some concerns would be China, and the desire to only select for boys. As medical tourism takes place (a couple could simply travel to a country were it is acceptable to choose gender) it would be an issue whose affects would have to be looked at a global scale.

Week six

In my opinion, there is definitely a difference in screening for a genetic disorder and screening for gender. However, I'm not sure that I have an issue with people screening for the gender of their child. While I understand that this comes very close to unethical, I think screening for gender just makes the cut. Eye color, hair color, personality however, I do no find acceptable. If screening for gender was allowed, it would have to be controlled very strictly. Maybe a couple should only be allowed to screen after their first child? I think that there is a way that could be found to do it that would be moral. Some concerns would be China, and the desire to only select for boys. As medical tourism takes place (a couple could simply travel to a country were it is acceptable to choose gender) it would be an issue whose affects would have to be looked at a global scale.

Week 6

I believe there is an absolute difference in screening for disease and gender. It is acceptable to screen for a genetic disorder because it is in the child's best interest. Genetic disorders can be very hard on the child, parents and family as a whole. They can be expensive to treat and care for, and the child may not receive the proper care. Screening for gender is unnecessary and leads to selection of all traits which will not benefit the child's survival.

Antoine and Naomi

It would be beneficial for the parents to have a child with the characteristics or phenotypes they prefer, but it would result in many different problems. Screening would trigger sex imbalance due to favoring. Also, this process would change the diversity of the world by increasing the population of the stronger favored phenotypes. It is a task of cheating the system, which is morally wrong because you are using technology to choose your child. However, I believe you could use it to check the likely hood of your child and the disease you are dealing with and fix the problem another way to better their lives. I would tell the parents that they should not play with the situation because it would be selfish.

There is a huge difference

There is a huge difference between screening for genetic diseases and for traits such as gender and phenotype. Genetic screening should be available to families that are considered high risk for genetic diseases, but screening should only be done for those diseases. Gender should not be chosen UNLESS the disease is sex-linked, and then the gender of the embryo is important but not because the parents want it one way or another. Screening for phenotypic characteristics such as hair color or eye color is basically eugenics and ever since Hitler, that kind of thing has been frowned upon. There are so many implications that can come from choosing phenotypes, especially discrimination. As a doctor, there is an ethical obligation to refuse the parent’s requests in this case and implant a random, healthy embryo, no matter the sex. They have a fifty-fifty shot anyways!

Week 6 blog response

While the couple should be able to screen for the presence of disease in their embryos, screening for gender type is disconcerting and borderline sickening. How far will people go to get the “perfect” baby? [About to get a bit philosophical with this…] Personally, I feel that if you live with your heart in the right place, and you work hard to achieve meaningful goals, everything else will fall into place; everything happens for a reason. If this couple were to have a girl instead of a boy, it is meant to be – end of story. If I were the doctor in this situation, I would try to explain the previous sentiment to this couple. Screening for anything other than serious disease is highly unethical. Over the course of evolutionary history, certain genotypes and associated phenotypes have proliferated more than others. Some of these events have occurred simply because of genetic drift, but many, MANY traits were selected because they play a key role in survival. We have no right to pick and choose from a pool of traits for which “Mother Nature” and “Father Time” have carefully selected. The uterus is not Build-A-Bear Workshop. Take what you get and love it as nature intended.

Response to week 6 blog

If I was the couple's doctor then I would not allow gender screening as there is a clear ethical & moral distinction between screening for diseases and screening for phenotype. The gender & other phenotypes of an individual have no effect on the survivability of the individual. However, screening for diseases guarantees that individuals will have a better quality of life and a higher life expectancy. If parents are given the opportunity to choose all allele types present in their offspring then we pose the risk of reducing the genetic diversity and also cause gender imbalance which already exists in many developing countries around the world, hence screening for phenotypes should not be made available. Genetic screening should definitely be available but only for high risk and high impact diseases.

Week 6

If I were a doctor I don’t believe I would agree to perform a genetic test to select for a certain gender. There is a huge difference between screening for a fatal or degenerative disease and screening for certain phenotype. If a genetic test were available for a disease that the family knows they may be predisposed for then I would have no problem in performing that test so that I could save the family from years of emotional and financial woes, but knowing the gender of your child before you even conceive does not really benefit the family from anything fatal in the future (unless there’s a sex-linked disease in question). If we start screening for gender in vitro then we’ll be heading down a slippery slope of manipulating conception until we are at a dangerous level of uniformity which could be detrimental to our existence and survival. Genetic screening should only be done for diseases.

week # 6- Social and Ethical issues

I think genetic screening for diseases are okay, especially for fatal or life incapacitating diseases. However, I think genetic screening for gender and other phenotypic test is not necessary. It might lead to people selecting for a certain type of sex, which might complicate things later on (e.g. too much gender imbalance). Also selecting for certain phenotypes might lead to discrimination (for job and socially in general), as some people might prefer certain features more to others.

Blog 6

If I were the doctor I would not let them screen the embryos based on gender. Screening for a genetic disease is vastly different from screening for phenotypic traits. Screening for genetic disease allows the child will have a good quality of life and the parents could avoid the financial and emotional hardships that accompany a genetic disease like CF. Checking for traits that do not have an effect on survival is ethically questionable and could lead to discriminatory programs similar to those that were implemented by Hitler. Genetic screening for fatal diseases should be allowed but if there is no threat to survival then genetic screening should not be allowed.

week 6 reply

Selecting an embryo based on phenotype characteristics I believe would be crossing the line of being ethical. Using technological advances in medicine to test for genetic diseases is an attempt to better the lives of children because people see the hardships children face with the diseases. The couple asking for specific phenotype traits in their embryos is in essence trying to play god. The thing that makes humans what they are is their genetic and phenotype diversity. If genetic testing for phenotypes was available and couples could choose specific traits they would be working to eliminate this diversity. Genetic screening should only be available for diseases because of the hardships they put on the individual and their family.

Genetic Testing for Phenotype

I personally do not see much of a difference between genetic testing for disease and choosing of alleles for specific phenotypes. While it is true that genetic testing of diseases can improve the quality of life of the eventually progeny, so can changing the alleles of a child to more preferred phenotypes. While it is understandable for the family to want healthy children, the reality is if you are choosing healthy alleles, why not just choose exactly what you want your child to look like. It can give them a better life and possibly more opportunities for wealth and happiness.

The problem with selecting alleles that have no impact on survival is that it is unnatural and this issue I'm sure someday will cause political and ethical strife because it is in a sense, playing God. I believe that if you are going to do any screening and allele changes, it only makes sense to make it all fair game or none of it but this is not an issue where the in between will make everyone happy.

Blog 6

This is an interesting dilemma which brings up several issues. First of all, as our society grows more and more scientifically capable, we absolutely should not deny tests to patients who need them. For instance, the couple in this example should be provided with the genetic screening for CF. By performing this test now, it would save the couple potentially decades of medical costs, stress, and additional heartache as CF patients typically only live ~40-50 years. If, per se, the genetic disorder in question was sex-linked, it would potentially necessitate the couple to predetermine the gender of their child. However, I personally believe that is the only circumstance under which gender should be selected for.

As the genetic counselor, I would of course never openly judge the parents or impose my beliefs on them, but I would advise them of the costs, insurance coverage, and moral implications of this choice. I would explain to them that performing genetic screening for gender will not only come at an additional cost, but insurance will not cover it as it has no medical necessity and that I would not feel comfortable writing the order to have this type of procedure performed, and give them the name of a different genetic counselor. I believe that there is a difference between performing genetic screening for medical purposes and performing it for superficial reasons.

By performing tests for phenotypic traits that have no impact on survival, we are opening up a can of worms. First, I think a decent analogy is that it has the potential to turn into Hitler's dreamworld. If parents were allowed to selectively choose the look of their child, the world may turn into an Aryan society with little to no genetic diversity. The population needs diversity in order to ensure survival of the species.

If I were the doctor I would

If I were the doctor I would not care, If I were asked to screen for gender and phenotype I would let the parents know because i believe its the parents right to know, even if they are screening a fatal disease as well. The parents would like to prevent having a child with a fatal disease so they do not have to deal with the consequence of baring a child that would surely result in an early death or an abnormal life style. But there will be a fine line where you can pick and choose what type of child you want by means of physical attributes, you will then step in to the world of genetically engineering a newborn.

Week 6 Response

Doctors should prohibit patients from choosing phenotypic traits that do not influence survival. Instead, they should explain to couples the risks of allowing such a practice. Screening for a disease, which is a controversial issue itself, can prevent future complications regarding the health of the child. However, screening for traits that are simply preferred by parents will create a child that has essentially been designed. The population may even lose genetic diversity as couples might select traits that are commonly seen as favorable. The only form of genetic screening that should be available includes traits that would threaten the child’s life. However, society would need to decide which traits are considered harmful enough, perpetuating further discussion on the boundaries of genetic screening.

Week 6 Blog

In my opinion, if one has the option of choosing which embryo to implant based on genetic disposition for a disease, then that person might as well have a say as to what gender the implanted embryo belongs to. Looking at susceptability for disease in someone's DNA is no different (and seemingly more 'prying') then simply identifying and counting chromosomes. I don't think that people should be able to screen for and choose what phenotype their child will have outside of gender, because in some instances its healthier for a breeding population to have phenotypically differerent members. If we simply selected every trait for our children, it is likely that we would see an overabundance of traits that correlate with success in our society, such as height, muscle tone, complexion, etc. Genetic screening should stick to the realm of identifying deadly alleles to eliminate physical or emotional suffering.

Blog 6 Entry

In the case I feel that I were the doctor I would not think it was ethical nor right for parents to be able to choose the sex of baby, nor any other trait of the child unless it was damaging to the child. The purpose of this screening in the first place was to find out if the parents were to have another child that they would avoid presence of a disease in a given embryo. I understand that fact if that parents would like to know if their child would inherit a certain disease that would greatly effected them, and be able to avoid that suffering. On the other hand I don’t thing we should you this type of genetic screening to help parents to decide certain types of traits for the child to inherit. I feel genetically engineering your children isn’t in the benefit of the child but the parents which in turn would not be ethical. This genetic screening should only be used detecting harmful diseases for the future children.

Week #6 - Social and Ethical Issues (due 2/25)

If the parents want to preform a particular test and that test is available then it is the parents decision. As the doctor you would have to abide by the wishes of the patient, provided that their mental state was normal. The difference between screening for a disease and screening for gender is that, unless there is some disease that results when the child is a certain gender selecting for gender doesn’t rectify any problem. In both cases you are looking for and selecting the embryo with a desired genotype. The problem becomes where do we stop. At what point do we cross the line between helping cure a potential disease and making unneeded changes. On this note phenotype tests should only be made available in cases where a mutation that would be deleterious to the individuals life is associated with it. By selecting for non essential genotypes a host of social problems could arise. For example discrimination against individuals with unaltered genotypes could be common place. Furthermore as is seen in wheat varieties a loss of genetic diversity could also be seen. This would be especially bad if a disease arose and the cure was part of the genetic diversity lost due to unnecessary selections. To conclude genetic tests should be made available if and only if they are screening for a problem that might be deleterious to the persons life should they contract those genes.

Week 6 Blog Entry

Screening for gender would be a morally questionable practice that doctors shouldn't perform. Checking for a genetic disease is permissible because having an unhealthy baby could lead to an avoidable life of hardships for the parents and the offspring. By checking for gender or any physical trait in a healthy embryo, parents and doctors are promoting discriminatory eugenics. Thus, screening that isn't focused on disease genotypes and/or phenotypes should not to be available for the public to use. Selecting against alleles not important for survival ensures that people with those alleles will be treated differently. Doing so would be in line with ideologies that fueled Nazi Germany. Genetic screening should strictly be for the physical well-being of the embryo.

Week #6 Response

In this case the doctor should not be able to disclose gender or phenotype in anyway. While I am strongly for being able to detect fatal diseases that greatly deter a normal life style and result in early death, to than decide to pick out phenotype and gender of your child goes to far. Some different cultures could begin to rapidly take advantage of this in particular cultures where males are preferred as this is more common. Once you begin distinguishing phenotypes and genders I believe you cross the line to genetically engineering your children which should not be done as it takes any uniqueness out of individuals.

Week #6 Response

If I was a doctor, I would not allow the parents to choose the sex of the baby, nor any other trait unless it would otherwise be fatal or crippling. This technology was made specifically to prevent the suffering of the parent and baby if a child expresses a fatal disease and further meddling with the process should be discouraged. If the parents want to have the sex of the baby revealed to them before it is birthed, that’s one thing, but selecting for specific traits would take away from the natural process of the creation of a new life. In addition, if the child knew that they parents had selected or wanted to select for certain traits that would not otherwise have been expressed, there would most likely be negative psychological effects on that child, suggesting that they weren’t naturally good enough for their parents. Unconditional love for a child should not be a function of their appearance - genetic screening should only been done for potentially fatal or crippling diseases.

Week 6 Blog

If I were the doctor, I wouldn’t tell the couple about the gender of the child and try to explain it to them that they shouldn’t be sexist and that girls and boys are equal. I feel like there is a huge difference between screenings for a genetic disease and gender. Genetic test for disease is good for everyone. No parents want to have children who have a genetic diseases, no one in general wants to have such kind of disease so if we allow screening for genetic disease it will allow everyone to lead a happy life. But if we allow screening for gender then it will lead to gender discrimination. I don’t think screening for phenotype should be available since it will lower the genetic variation. Everyone would look similar and there would be no uniqueness about one’s look. Genetic screening that looks for genetic disease or any kind of abnormality should be available for screening.

Week 6 Comment

There is a huge difference between screening for a genetic disease and gender. If I were the doctor, I would not screen for gender because increase use of such screening would only eventually lead to discrimination. People would want to selectively have boys or girls or a fair baby with blue eyes and so on and so forth. Unnecessarily meddling with nature is never without consequences. Genetic screening should only be available for life threatening disorders or the ones that involve incurable pain. A baby born with cystic fibrosis will have to suffer a lot and so it is understandable that the parents would want to screen for it. But if a trait does not have an impact on survival and health it should not be selected for. Nothing would be natural then, we might as well have genetically engineered babies.

Week 6 Response

I believe there is a big difference in screening between gender and disease. If we can start screening for gender and other phenotypes then soon the population's phenotypic variation would decrease. People would start looking more alike in some aspects (hair color, height...). And there is a chance an off-balance of male/female ratio can occur. I believe this is something we should not have control over. Ridding of disease is beneficial to that individual, their family, and the population. Altering a phenotype that really has not much to do with the persons fitness is not very beneficial to anyway except the parents personal wants. The only genetic screening available should be for screenings that affect the individuals fitness; for example, screening for disease and abnormalities.